HomeMy WebLinkAbout2004-251I RESOLUTION NO. 2004-251
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RESOLUTION RATIFYING THE SUBMITTAL OF A GRANT APPLICATION
3 TO THE FEDERAL DEPARTMENT OF EDUCATION IN THE AMOUNT OF $496,871
4 TO PROVIDE YOUTH MENTORING SERVICES FOR A 36 MONTH PERIOD
BEGINNING SEPTEMBER 1, 2004 THROUGH AUGUST 31, 2007.
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BE IT RESOLVED BY THE MAYOR AND COMMON COUNCIL OF THE CITY
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OF SAN BERNARDINO AS FOLLOWS:
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8 SECTION 1. The Mayor and Common Council of the City of San Bernardino hereby
9 ratify the submittal of a grant application to the Federal Department of Education in the amount
$496,871 relating to the provision of youth mentoring services for the period of September 1,
11112004 through August 31, 2007. A copy of said application is hereby attached hereto, marked
Exhibit "A", and incorporated herein by reference as fully as though set forth at length.
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2004-251
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RESOLUTION RATIFYING THE SUBMITTAL OF A GRANT APPLICATION
THE FEDERAL DEPARTMENT OF EDUCATION IN THE AMOUNT OF $496,871
PROVIDE YOUTH MENTORING SERVICES FOR A 36 MONTH PERIOD
INNING SEPTEMBER 1, 2004 THROUGH AUGUST 31, 2007.
I HEREBY CERTIFY that the foregoing Resolution was duly adopted by the Mayor and
it.
)n Council of the City of San Bernardino at a reg. meeting thereof, held on the 2nd
of August , 2004, by the following vote, to wit:
Members: AYES NAYS
x
LLE x
GINNIS x
.RY x
x
x
ABSTAIN ABSENT
CAMMACK x
Cit Jerk
The foregoing resolution is hereby approved this day of August 2004.
Susan Longville, Mayor Pro Tern
City of San Bernardino
wed as to
and legal content:
ES F. PENMAN,
Attorney
2004-251
Application for Federal
Education Assistance (ED 424)
Applicant Information
U.S. Department of Education
Form Approved
OMB No. 1875-0106
Fxp. 11/30/2004
1. Name and Address Organizational Unit
Legal Name: The City of San Bernardino Parks, Recreation and Community Services Department The City of San Bemardino
Address: 547 North Sierra Way Mentoring Program
San Bernardino CA San Bernardino 92410-4816
2. Applicant's D-U-N-S Number L8J_0J_5J_3_L4J_9J_2_L0J_6J
3. Applicant's T-I-N L9_L5J - 16J_0_10_L0J_7J-7J0_I
4. Catalog of Federal Domestic Assistance #: 84 _1_L0_L4_LB_j
Title: Director of Parks & Recreation Service Department
5. Project Director: Lemuel P. Randolph
Address: 547 North Sierra Way
San Bernardino CA 92410 4816
City State Zip code + 4
Tel. #: ( 909 ) 887-1847 Fax #: (909) 384- 5167
E-Mail Address: randolph_le@sbcfty.org
Application Information
9. Type of Submission:
-PreApplication
Construction
Non -Construction
-Application
Construction
Non -Construction
10. Is application subject to review by Executive Order 12372 process?
_ Yes (Date made available to the Executive Order 12372
process for review): _l_l
_X_ No (If "No,"check appropriate box below.)
_ Program is not covered by E.O. 12372.
Program has not been selected by State for review.
11. Proposed Project Dates: _9_/_O7_/_2004 / 31 / 2007
Start Date: End Date:
State County ZIP Code + 4
6. Novice Applicant _Yes _X No
7. Is the applicant delinquent on any Federal debt? _Yes X_No
(if'Yes,"attach an explanation.)
8. Type of Applicant (Enter appropriate letterin the box.) L_L_I
A - State
F - Independent School District
B - Local
G - Public College or University
C - Special District
H - Private, Non-profit College or
University
D - Indian Tribe
I - Non-profit Organization
E - Individual
J - Private, Profit -Making Organization
K - Other (Specify):
12. Are any research activities involving human subjects planned at
any time during the proposed project period?
Yes (Go to 12a.) _X_ No (Go to ftem 13.)
12a. Are all the research activities proposed designated to be
exempt from the regulations?
_ Yes (Provide Exemption(s) #):
_X_ No (Provide Assurance #):
13. Descriptive Title of Applicant's Project:
The City of San Bernardino Mentoring Program
(CSBMP)
Estimated Funding
Authorized Representative Information
15. To the best of my knowledge and belief, all data in this preapplication/application are true
14a. Federal
E 162,896. 00
and correct. The document has been duly authorized by the governing body of the applicant
b. Applicant
E . 00
and the applicant will comply with the attached assurances if the assistance is awarded.
c. State
E . 00
a. Authorized Representative (Please type or print name clearly.)
d. Local
E _ 71,280. 00
Lemuel P. Randolph
e. Other
E 7.920. 00
to. Title: Director of Parks & Recreation Services Department
f. Program Income
E . 00
c. Tel. #: ( 909 ) 384-5030 Fax #: ( 909 ) 384-5160
it. E-Mail Address: randolph_le@sbcity.org
g. TOTAL
E 242,496. 00
e. Signature"thorize Rep 9n e
--Ya�Lll Date? /2—/ OY
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2004-251
Instructions for Form ED 424
1. Legal Name and Address. Enter the legal name of applicant and the
name, of the primary organizational unit which will undertake the
assistance activity.
2. D-U-NS Number. Enter the appticant's D-U-N-S Number. If your
organization does not have a D-U-N-S Number, you can obtain the
number by calling 1-800-333-0505 or by completing a D-U-N-S
Number Request Form. The form can be obtained As the Internet at
the following URL: http://wv6w.dnb.coin.
3. Tax Identification Number. Enter the taxpayer's identification number
as assigned by the Internal Revenue Service.
4. Catalog of Federal Domestic Assistance (CFDA) Number. Enter
the CFDA number and title of the program under which assistance is
requested. The CFDA number can be found in the federal register
notice and the application package.
5. Project Director. Name, address, telephone and fax numbers, and e-
mail address of the person to be contacted on matters involving this
application.
6. Novice Applicant. Check "Yes" or *No" only if assistance is being
requested under a program that gives special consideration to novice
applicants. Otherwise, leave blank.
Check "Yes" if you meet the requirements for novice applicants
specified In the regulations in 34 CFR 75,225 and included on the
attached page entitled "Definitions for Form ED 424.' By checking
"Yes" the applicant cerfifies that it meets these novice applicant
requirements. Check "No" if you do not meet the requirements for
novice applicants.
7. Federal Debt Delinquency. Check "Yes" if the applicants
organization is delinquent on any Federal debt (This question refers
to the applicant's organization and not to the person who signs as the
authorized representative. Categories of debt include delinquent audit
disallowances, loans and taxes.) Otherwise, check "No."
8. Type of Applicant. Enter the appropriate letter in the box provided.
9. Type of Submission. See "Definitions for Form ED 424" attached.
1O.Executive Order 12372. See "Definitions for Form ED 424" attached.
Check "Yes" if the application is subject to review by E.O. 12372.
Also, please enter the month, day, and four (4) digit year (e.g.,
12/12/2001). Otherwise, check "No."
11. Proposed Project Dates. Please enter the month, day, and four (4)
digit year (e.g., 12/1212001).
12. Human Subjects Research. (See I.A. "Definitions" in attached page
entitled "Definitions for Form ED 424.")
If Not Human Subjects Research. Check "No" if research activities
involving human subjects are not planned at any time during the
proposed project period. The remaining parts of Item 12 are then not
applicable.
If Human Subjects Research. Check "Yes" if research activities
involving human subjects are planned at any time during the
proposed project period, either at the applicant organization or at any
other performance site or collaborating institution. Check "Yes" even
if the research is exempt from the regulations for the protection of
human subjects. (See I.B. "Exemptions" in attached page entitled
"Definitions for Form ED 424.")
12a. If Human Subjects Research is Exempt from the Human Subjects
Regulations. Check "Yes" if ail the research activities proposed are
designated to be exempt from the regulations. Insert the exemption
number(s) corresponding to one or more of the six exemption
categories listed in I.B. "Exemptions." In addition, follow the
instructions in IIA. "Exempt Research Narrative" in the attached page
entitled 'Definitions for Form ED 424." Insert this narrative
immediately following the ED 424 face page.
12a. If Human Subjects Research is Not Exempt from Human Subjects
Regulations. Check 'No" if some or all of the planned research
activities are covered (not exempt). In addition, follow the instructions
in II.B. "Nonexempt Research Narrative" in the page entitled
"Definitions for Form ED 424." Insert this narrative immediately
following the ED 424 face page.
12a. Human Subjects Assurance Number. If the applicant has an
approved Federal Wide (FWA) or Multiple Project Assurance (MPA)
with the Office for Human Research Protections (OHRP), U.S.
Department of Health and Human Services, that covers the specific
activity, Insert the number in the space provided. If the applicant does
not have an approved assurance on file with OHRP, enter "None.' In
this case, the applicant, by signature on the face page, is declaring
that it will comply with 34 CFR 97 and proceed to obtain the human
subjects assurance upon request by the designated ED official. If the
application is recommended/selected for funding, the designated ED
official will request that the applicant obtain the assurance within 30
days after the specific formal request.
Note about Institutional Review Board Approval. ED does not require
certification of Institutional Review Board approval with the application.
However, if an application that involves non-exempt human subjects
research is recommended/selected for funding, the designated ED official
will request that the applicant obtain and send the certification to ED within
30 days after the formal request
13. Project Title. Enter a brief descriptive title of the project. If more than
one program is involved, you should append an explanation on a
separate sheet. If appropriate (e.g., construction or real property
projects), attach a map showing project location. For preapplications,
use a separate sheet to provide a summary description of this project.
14. Estimated Funding. Amount requested or to be contributed during the
first funding/budget period by each contributor. Value of in -kind
contributions should be Included on appropriate lines as applicable. If
the action will result in a dollar change to an existing award. indicate
only the amount of the change. For decreases, enclose the amounts
in parentheses. If both basic and supplemental amounts are included,
show breakdown on an attached sheet. For multiple program funding,
use totals and show breakdown using same categories as item 14.
15. Certification. To be signed by the authorized representative of the
applicant. A copy of the governing body's authorization for you to sign
this application as official representative must be on file in the
applicant's office. Be sure to enter the telephone and fax number and
e-mail address of the authorized representative. Also, in item 15e,
please enter the month, day, and four (4) digit year (e.g., 12/12/2001)
in the date signed field.
II. Paperwork Burden Statement. According to the Paperwork
Reduction Act of 1995, no persons are required to respond to a collection
of information unless such collection displays a valid OMB control number.
The valid OMB control number for this information collection is 1875-0106.
The time required to complete this information collection is estimated to
average between 15 and 45 minutes per response, including the time to
review instructions, search existing data resources, gather the data
needed, and complete and review the information collection. If you have
any comments concerning the accuracy of the estimate(s) or
suggestions for improving this form, please write to: U.S. Department
of Education, Washington, D.C. 20202.4651. If you have comments or
concerns regarding the status of your individual submission of this
form write directly to: Joyce I. Mays, Application Control Center, U.S.
Department of Education, 7th and D Streets, S.W. ROB-3, Room 3633,
Washington, D.C. 20202-4725
2004-251 Definitions for Form ED 424
Novice Applicant (See 34 CFR 75.225). For discretionary grant programs under which the Secretary gives special consideration to novice applications, a
novice applicant means any applicant for a grant from ED that —
Has never received a grant or subgrant under the program from which it seeks funding;
Has never been a member of a group application, submitted in accordance with 34 CFR 75.127-75.129. that received a grant under the program
from which it seeks funding; and
Has not had an active discretionary grant from the Federal government in the five years before the deadline date for applications under the
program. For the purposes of this requirement a grant is active until the end of the grant's project or funding period, Including any extensions of
those periods that extend the grantee's authority to obligate funds.
In the case of a group application submitted in accordance with 34 CFR 75.127-75.129, a group includes only parties that meet the requirements listed
above.
Type of Submission. "Construction" includes construction of new buildings and acquisition, expansion, remodeling, and alteration of existing buildings,
and initial equipment of any such buildings, or any combination of such activities (including architects' fees and the cost of acquisition of land).
"Construction" also includes remodeling to meet standards, remodeling designed to conserve energy, renovation or remodeling to accommodate new
technologies, and the purchase of existing historic buildings for conversion to public libraries. For the purposes of this paragraph, the term "equipment"
includes machinery, utilities, and built-in equipment and any necessary enclosures or structures to house them; and such tern includes all other Items
necessary for the functioning of a particular facility as a facility for the provision of library services.
Executive Order 12372. The purpose of Executive Order 12372 is to foster an intergovernmental partnership and strengthen federalism by relying on
State and local processes for the coordination and review of proposed Federal financial assistance and direct Federal development. The application
notice, as published in the Federal Register, informs the applicant as to whether the program is subject to the requirements of E.O. 12372. In addition, the
application package contains information on the State Single Point of Contact. An applicant is still eligible to apply for a grant or grants even if Its
respective State, Territory, Commonwealth, etc. does not have a State Single Point of Contact. For additional information on E.O. 12372 go to
http://www.cfda.gov/publicteol2372.htm.
PROTECTION OF HUMAN SUBJECTS IN RESEARCH
I. Definitions and Exemptions
A. Definitions.
A research activity Involves human subjects If the activity is research, as defined in the Department's regulations, and the research activity will
Involve use of human subjects, as defined in the regulations.
—Research
The ED Regulations for the Protection of Human Subjects, Title 34. Code of Federal Regulations, Part 97, define research as "a systematic Investigation,
including research development, testing and evaluation, designed to develop or contribute to generalizable knowledge." If an activity follows a deliberate
plan whose purpose is to develop or contribute to generalizable knowledge @ is research. Activities which meet this definition constitute research whether
or not they are conducted or supported under a program which is considered research for other purposes. For example, some demonstration and service
programs may include research activities.
—Human Subject
The regulations define human subject as "a living individual about whom an investigator (whether professional or student) conducting research obtains (1)
data through intervention or interaction with the individual, or (2) identifiable private information." (1) If an activity involves obtaining information about a
living person by manipulating that person or that person's environment, as might occur when a new instructional technique is tested, or by communicating
or interacting with the individual, as occurs with surveys and interviews, the definition of human subject is met. (2) If an activity involves obtaining private
information about a living person in such a way that the information can be linked to that individual (the identity of the subject is or may be readily
determined by the investigator or associated with the information), the definition of human subject is met. [Private information includes information about
behavior that occurs in a context in which an individual can reasonably expect that no observation or recording is taking place, and information which has
been provided for specific purposes by an individual and which the individual can reasonably expect will not be made public (for example, a school health
record).]
B. Exemptions.
Research activities in which the only involvement of human subjects will be in one or more of the following six categories of exemptions are not covered
by the regulations:
(1) Research conducted in established or commonly accepted educational settings, involving normal educational practices, such as (a) research on
regular and special education instructional strategies, or (b) research on the effectiveness of or the comparison among instructional techniques, curricula,
or classroom management methods.
(2) Research involving the use of educational tests (cognifive, diagnostic, aptitude, achievement), survey procedures, interview procedures or observation
of public behavior, unless: (a) information obtained is recorded in such a manner that human subjects can be identified, directly or through identifiers linked
to the subjects; and (b) any disclosure of the human subjects' responses outside the research could reasonably place the subjects at risk of criminal or civil
liability or be damaging to the subjects' financial standing, employability, or reputation. ff the subjects are children, exemption 2 applies only to
research Involving educational tests and observations of public behavior when the Investlgator(s) do not participate in the activities being
observed. Exemption 2 does not apply if children are surveyed or Interviewed or If the research involves observation of public behavior and
the invesdgator(s) participate in the activities being observed. [Children are defined as persons who have not attained the legal age for consent to
treatments or procedures involved in the research, under the applicable law or jurisdiction in which the research will be conducted.)
55
2004-251
(3) Research involving the use of educational tests (cognifive, diagnostic, aptitude, achievement), survey procedures, interview procedures or observation
of public behavior that is not exempt under section (2) above, if the human subjects are elected or appointed public officials or candidates for public office;
or federal statute(s) require(s) without exception that the confidentiality of the personally identifiable Information will be maintained throughout the research
and thereafter.
(4) Research involving the collection or study of existing data, documents, records, pathological specimens, or diagnostic specimens, if these sources are
publicly available or if the information is recorded by the Investigator in a manner that subjects cannot be identified, directly or through identifiers linked to
the subjects.
(5) Research and demonstration projects which are conducted by or subject to the approval of department or agency heads, and which are designed to
study, evaluate, or otherwise examine: (a) public benefit or service programs; (b) procedures for obtaining benefits or services under those programs; (c)
possible changes in or alternatives to those programs or procedures; or (d) possible changes in methods or levels of payment for benefits or services
under those programs.
(6) Taste and food quality evaluation and consumer acceptance studies, (a) if wholesome foods without additives are consumed or (b) if a food is
consumed that contains a food ingredient at or below the level and for a use found to be safe, or agricultural chemical or environmental contaminant at or
below the level found to be safe, by the Food and Drug Administration or approved by the Environmental Protection Agency or the Food Safety and
Inspection Service of the U.S. Department of Agriculture.
Instructions for Exempt and Nonexempt Human Subjects Research Narratives
If the applicant marked Wes' for Item 12 on the ED 424, the applicant must provide a human subjects "exempt research" or 'nonexempt research"
narrative and insert it immediately following the ED 424 face page.
A. Exempt Research Narrative.
If you marked "Yes" for item 12 a. and designated exemption numbers(s), provide the "exempt research" narrative. The narrative must contain sufficient
information about the involvement of human subjects in the proposed research to allow a determination by ED that the designated exemption(s) are
appropriate. The narrative must be succinct.
B. Nonexempt Research Narrative
If you marked "No" for item 12 a. you must provide the "nonexempt research" narrative. The narrative must address the following seven points. Although
no specific page limitation applies to this section of the application, be succinct.
(1) Human Subjects Involvement and Characteristics: Provide a detailed description of the proposed involvement of human subjects. Describe the
characteristics of the subject population, including their anticipated number, age range, and health status. Identify the criteria for inclusion or exclusion of
any subpopulation. Explain the rationale for the involvement of special classes of subjects, such as children, children with disabilities, adults with
disabilities, persons with mental disabilities, pregnant women, prisoners. Institutionalized individuals, or others who are likely to be vulnerable
(2) Sources of Materials: Identify the sources of research material obtained from individually identifiable living human subjects in the forth of specimens,
records, or data. Indicate whether the material or data will be obtained specifically for research purposes or whether use will be made of existing
specimens, records, or data.
(3) Recruitment and Informed Consent: Describe plans for the recruitment of subjects and the consent procedures to be followed. Include the
circumstances under which consent will be sought and obtained, who will seek it. the nature of the information to be provided to prospective subjects, and
the method of documenting consent. State 1 the Institutional Review Board (I RB) has authorized a modification or waiver of the elements of consent or
the requirement for documentation of consent.
(4) Potential Risks: Describe potential risks (physical, psychological, social, legal, or other) and assess their likelihood and seriousness. Where
appropriate, describe alternative treatments and procedures that might be advantageous to the subjects.
(5) Protection Against Risk: Describe the procedures for protecting against or minimizing potential risks, including risks to confidentiality, and assess
their likely effectiveness. Where appropriate, discuss provisions for ensuring necessary medical or professional intervention in the event of adverse effects
to the subjects. Also, where appropriate, describe the provisions for monitoring the data collected to ensure the safety of the subjects.
(6) Importance of the Knowledge to be Gained: Discuss the importance of the knowledge gained or to be gained as a result of the proposed research.
Discuss why the risks to subjects are reasonable in relation to the anticipated benefits to subjects and in relation to the importance of the knowledge that
may reasonably be expected to result.
(7) Collaborating Site(s): If research involving human subjects will take place at collaborating site(s) or other performance site(s), name the sites and
briefly describe their involvement or role in the research.
Copies of the Department of Education's Regulations for the Protection of Human Subjects, 34 CFR Part 97 and other pertinent materials on the
protection of human subjects In research are available from the Grants Policy and Oversight Staff, Office of the Chief Financial Officer, U.S.
Department of Education, Washington, D.C. 20202-4248, telephone: (202) 708-8263, and on the U.S. Department of Education's Protection of
Human Subjects In Research Web Site at htip://www.ed.gov/aboutlof ce&4istlocfolhumensub.htrni
2004-251
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2004-251
According to the Paperwork Reduction Act of 1995, no persons are required to respond to a
collection of information unless such collection displays a valid OMB control number. The valid
OMB control number for this information collection is 1890-0004. The time required to complete
this information collection is estimated to vary from 13 to 22 hours per response, with an average of
17.5 hours per response, including the time to review instructions, search existing data sources,
gather the data needed, and complete and review the information collection. If you have any
comments concerning the accuracy of the time estimate(s) or suggestions for improving this form,
please write to: U.S. Department of Education, Washington, D.C. 20202-4651. If you have
comments or concerns regarding the status of your individual submission of this form, write directly
to (insert program office), U.S. Department of Education, 400 Maryland Avenue, S.W., Washington,
D.C.20202.
INSTRUCTIONS FOR ED FORM 524
General Instructions
This form is used to apply to individual U.S. Department of Education discretionary grant programs.
Unless directed otherwise, provide the same budget information for each year of the multi -year
funding request. Pay attention to applicable program specific instructions, if attached.
Section A - Budget Summary U.S. Department of Education Funds
All applicants must complete Section A and provide a breakdown by the applicable budget
categories shown in lines 1-11.
Lines 1-11, columns (a)-(e): For each project year for which funding is requested, show the total
amount requested for each applicable budget category.
Lines 1-11, column (f): Show the multi -year total for each budget category. If funding is requested
for only one project year, leave this column blank.
Line 12, columns (a)-(e): Show the total budget request for each project year for which funding is
requested.
Line 12, column (f): Show the total amount requested for all project years. If funding is requested
for only one year, leave this space blank.
Section B - Budget Summary Non -Federal Funds
If you are required to provide or volunteer to provide matching funds or other non -Federal
resources to the project, these should be shown for each applicable budget category on lines 1-11
of Section B.
Lines 1-11, columns (a)-(e): For each project year for which matching funds or other contributions
are provided, show the total contribution for each applicable budget category.
Lines 1-11, column (f): Show the multi -year total for each budget category. If non -Federal
contributions are provided for only one year, leave this column blank.
Line 12, columns (a)-(e): Show the total matching or other contribution for each project year.
Line 12, column (f): Show the total amount to be contributed for all years of the multi -year project.
If non -Federal contributions are provided for only one year, leave this space blank.
W
2004-251
Section C - Other Budget Information Pay attention to applicable program specific instructions, if
attached.
t. Provide an itemized budget breakdown, by project year, for each budget category listed in
Sections A and B. For grant projects that will be divided into two or more separately budgeted
major activities or sub -projects, show for each budget category of a project year the breakdown
of the specific expenses attributable to each sub -project or activity.
2. If applicable to this program, enter the type of indirect rate (provisional, predetermined, final or
fixed) that will be in effect during the funding period. In addition, enter the estimated amount of
the base to which the rate is applied, and the total indirect expense.
3. If applicable to this program, provide the rate and base on which fringe benefits are calculated.
4. Provide other explanations or comments you deem necessary.
2004-251
Mentoring Program — Program Specific Assurances
for Local Educational Agencies
In addition to the standard assurances included with this application package, all applicants
that are local educational agencies must review and sign the following assurances:
As the duly authorized representative of the applicant, I hereby certify that:
1. Assure that no mentor will be assigned to mentor so many children that the
assignment will undermine the mentor's ability to be an effective mentor or the
mentor's ability to establish a close relationship (a one-to-one relationship, where
practicable) with each mentored child;
2. Assure that the mentoring program will provide children with a variety of experiences
and support, including:
(i) Emotional support;
(ii) Academic assistance; and
(iii) Exposure to experiences that the children might not otherwise encounter on
their own;
3. Assure that the mentoring program will be monitored to ensure that each child
assigned a mentor benefits from that assignment and that the child will be assigned a
new mentor if the relationship between the original mentor and the child is not
beneficial to the child;
4. Assure that it will: (1) establish clear, measurable performance goals; and (2) collect
and report to the Department data related to the established Government Performance
and Results Act (GPRA) performance indicators for the Mentoring Programs grant
competition. We will reject any application that does not contain this assurance.
N/A
Signature of Authorized Certifying Official
N/A
Organization Name
N/A
Title
N/A
Date
61
2004-251
Mentoring Program — Program Specific Assurances
for Community -Based Organizations
In addition to the standard assurances included with this application package, all applicants
that are community -based organizations must review and sign the following assurances:
As the duly authorized representative of the applicant, I hereby:
1. Assure that:
a. It is an eligible applicant under the definitions provided in the Federal Register
notice and in this application package;
b. Timely and meaningful consultation with a LEA or private school has taken place
during the design and/or development of the proposed program;
c. LEA or private school staff will participate in the identification and referral of
students to the CBO's proposed program;
d. The LEA or private school will participate in the collection of data related to the
established GPRA performance indicators for the Mentoring Programs grant
competition.
2. Assure that no mentor will be assigned to mentor so many children that the
assignment will undermine the mentor's ability to be an effective mentor or the
mentor's ability to establish a close relationship (a one-to-one relationship, where
practicable) with each mentored child;
�3. Assure that the mentoring program will provide children with a variety of experiences
and support, including:
(i) Emotional support;
(ii) Academic assistance; and
(iii) Exposure to experiences that the children might not otherwise encounter on
their own;
4. Assure that the mentoring program will be monitored to ensure that each child
assigned a mentor benefits from that assignment and that the child will be assigned a
new mentor if the relationship between the original mentor and the child is not
beneficial to the child;
5. Assure that it will: (1) establish clear, measurable performance goals; and (2) collect
and report to the Department data related to the established Government Performance
and Results Act (GPRA) performance indicators for the Mentoring Programs grant
competition. We will reject any application that does not contain this assurance.
Director of Parks & Recreation Services
Signatur f "orizWd Certifying Official Title
The City of San Bernardino Parks & Recreation
Organization Name Date
62
CERTIFICATIONS REGARDING LOBBYING; DEBARMENT, SUSPENSION AND OTHER
RESPONSIBILITY MATTERS; AND DRUG -FREE WORKPLACE REQUIREMENTS
'Applicants should refer to the regulations cited below to determine the certification to which they are required to attest. Applicants
should also review the instructions for certification included in the regulations before completing this forth. Signature of this forth
provides for compliance with certification requirements under 34 CFR Part 82, "New Restrictions on Lobbying," and 34 CFR Part 85,
"Government -wide Debarment and Suspension (Nonprocurement) and Government -wide Requirements for Drug -Free Workplace
(Grants)." The certifications shall be treated as a material representation of fact upon which reliance will be placed when the
Department of Education determines to award the covered transaction, grant, or cooperative agreement.
1. LOBBYING
As required by Section 1352, Title 31 of the U.S. Code, and
implemented at 34 CFR Part 82, for persons entering into a grant
or cooperative agreement over $100,000, as defined at 34 CFR
Part 82, Sections 82.105 and 82.110, the applicant certifies that:
(a) No Federal appropriated funds have been paid or will be paid,
by or on behalf of the undersigned, to any person for influencing or
attempting to influence an officer or employee of any agency, a
Member of Congress, an officer or employee of Congress, or an
employee of a Member of Congress in connection with the making
of any Federal grant, the entering into of any cooperative
agreement, and the extension, continuation, renewal, amendment,
or modification of any Federal grant or cooperative agreement;
(b) If any funds other than Federal appropriated funds have been
paid or will be paid to any person for influencing or attempting to
influence an officer or employee of any agency, a Member of
Congress, an officer or employee of Congress, or an employee of
a Member of Congress in connection with this Federal grant or
cooperative agreement, the undersigned shall complete and
submit Standard Form - LLL, "Disclosure Form to Report
Lobbying," in accordance with its instructions;
(c) The undersigned shall require that the language of this
certification be included in the award documents for all subawards
at all tiers (including subgrants, contracts under grants and
cooperative agreements, and subcontracts) and that all
subrecipients shall certify and disclose accordingly.
2. DEBARMENT, SUSPENSION, AND OTHER
RESPONSIBILITY MATTERS
As required by Executive Order 12549, Debarment and
Suspension, and implemented at 34 CFR Part 85, for prospective
participants in primary covered transactions, as defined at 34 CFR
Part 85, Sections 85.105 and 85.110--
A. The applicant certifies that it and its principals:
(a) Are not presently debarred, suspended, proposed for
debarment, declared ineligible, or voluntarily excluded from
covered transactions by any Federal department or agency;
(b) Have not within a three-year period preceding this application
been convicted of or had a civil judgement rendered against them
for commission of fraud or a criminal offense in connection with
obtaining, attempting to obtain, or performing a public (Federal,
State, or local) transaction or contract under a public transaction;
violation of Federal or State antitrust statutes or commission of
embezzlement, theft, forgery, bribery, falsification or destruction of
records, making false statements, or receiving stolen property;
(c) Are not presently indicted for or otherwise criminally or civilly
charged by a governmental entity (Federal, State, or local) with
commission of any of the offenses enumerated in paragraph (2)(b)
of this certification; and
(d) Have not within a three-year period preceding this application
had one or more public transaction (Federal, State, or local)
terminated for cause or default; and
B. Where the applicant is unable to certify to any of the
statements in this certification, he or she shall attach an
explanation to this application.
3. DRUG -FREE WORKPLACE
(GRANTEES OTHER THAN INDIVIDUALS)
As required by the Drug -Free Workplace Act of 1988, and
implemented at 34 CFR Part 85, Subpart F, for grantees, as
defined at 34 CFR Part 85, Sections 85.605 and 85.610 -
A. The applicant certifies that it will or will continue to provide a
drug -free workplace by:
(a) Publishing a statement notifying employees that the unlawful
manufacture, distribution, dispensing, possession, or use of a
controlled substance is prohibited in the grantee's workplace and
specifying the actions that will be taken against employees for
violation of such prohibition;
(b) Establishing an on -going drug -free awareness program to
inform employees about:
(1) The dangers of drug abuse in the workplace;
(2) The grantee's policy of maintaining a drug -free workplace;
(3) Any available drug counseling, rehabilitation, and employee
assistance programs; and
(4) The penalties that may be imposed upon employees for drug
abuse violations occurring in the workplace;
(c) Making it a requirement that each employee to be engaged in
the performance of the grant be given a copy of the statement
required by paragraph (a);
(d) Notifying the employee in the statement required by paragraph
(a) that, as a condition of employment under the grant, the
employee will:
(1) Abide by the terms of the statement; and
(2) Notify the employer in writing of his or her conviction for a
violation of a criminal drug statute occurring in the workplace no
later than five calendar days after such conviction;
63
(e) Noiltying the agency, in writing, within 10 calendar days
after receiving notice under subparagraph (d)(2) from an
employee or otherwise receiving actual notice of such
conviction. Employers of convicted employees must provide
notice, including position title, to: Director, Grants Policy and
Oversight Staff, U.S. Department of Education, 400 Maryland
Avenue, S.W. (Room 3652, GSA Regional Office Building No.
3), Washington, DC 20202-4248. Notice shall include the
identification number(s) of each affected grant;
(f) Taking one of the following actions, within 30 calendar days
of receiving notice under subparagraph (d)(2), with respect to
any employee who is so convicted:
(1) Taking appropriate personnel action against such an
employee, up to and including termination, consistent with the
requirements of the Rehabilitation Act of 1973, as amended; or
(2) Requiring such employee to participate satisfactorily in a
drug abuse assistance or rehabilitation program approved for
such purposes by a Federal. State, or local health, law
enforcement, or other appropriate agency;
(g) Making a good faith effort to continue to maintain a
drug -free workplace through implementation of paragraphs
(a), (b), (c), (d), (e), and (f).
B. The grantee may insert in the space provided below the
site(s) for the performance of work done in connection with the
specific grant:
Place of Performance (Street address. city, county, state, zip
code)
547 North Sierra Way
San Bernardino, CA
92410
Check [ j if there are workplaces on file that are not identified
here.
DRUG -FREE WORKPLACE
(GRANTEES WHO ARE INDIVIDUALS)
As required by the Drug -Free Workplace Act of 1988, and
implemented at 34 CFR Part 85, Subpart F, for grantees, as
defined at 34 CFR Part 85, Sections 85.605 and 85.610-
A. As a condition of the grant, I certify that I will not engage in
the unlawful manufacture, distribution, dispensing, possession,
or use of a controlled substance in conducting any activity with
the grant; and
B. If convicted of a criminal drug offense resulting from a
violation occurring during the conduct of any grant activity, I will
report the conviction, in writing, within 10 calendar days of the
conviction, to: Director, Grants Policy and Oversight Staff,
Department of Education, 400 Maryland Avenue, S.W. (Room
3652, GSA Regional Office Building No. 3), Washington, DC
20202-4248. Notice shall include the identification numbers)
of each affected grant.
As the duly authorized representative of the applicant, I hereby certify that the applicant will comply with the above certifications.
NAME OF APPLICANT
PR/AWARD NUMBER AND / OR PROJECT NAME
The City of San Bernardino Parks, Recreation and Community Services Department The City of San Bernardino Mentoring Frog.
PRINTED NAME AND TITLE OF AUTHORIZED REPRESENTATIVE
Lemuel P. Randolph Director of Parks & Recreation Services Department
SIGNATURE
LAIX01111111w,
DATE
12/98
MI
2004-251
Certification Regarding Debarment, Suspension, Ineligibility and
Voluntary Exclusion — Lower Tier Covered Transactions
This certification is required by the Department of Education regulations implementing Executive Order 12549, Debarment and Suspension, 34
CFR Part 85, for all lower tier transactions meeting the threshold and tier requirements stated at Section 85.110.
Instructions for Certification
1. By signing and submitting this proposal, the prospective lower tier participant is providing the certification set out below.
2. The certification in this clause is a material representation of fact upon which reliance was placed when this transaction was entered into. If it
is later determined that the prospective lower tier participant knowingly rendered an erroneous certification, in addition to other remedies
available to the Federal Government, the department or agency with which this transaction originated may pursue available remedies, including
suspension and/or debarment.
3. The prospective lower tier participant shall provide immediate written notice to the person to which this proposal is submitted if at any time
the prospective lower tier participant learns that its certification was erroneous when submitted or has become erroneous by reason of changed
circumstances.
4. The terms "covered transaction," "debarred," "suspended," "ineligible," "lower tier covered transaction," "participant," " person," "primary
covered transaction," " principal," "proposal," and "voluntarily excluded," as used in this clause, have the meanings set out in the Definitions and
Coverage sections of rules implementing Executive Order 12549. You may contact the person to which this proposal is submitted for assistance
in obtaining a copy of those regulations.
5. The prospective lower tier participant agrees by submitting this proposal that, should the proposed covered transaction be entered into, it
shall not knowingly enter into any lower tier covered transaction with a person who is debarred, suspended, declared ineligible, or voluntarily
excluded from participation in this covered transaction, unless authorized by the department or agency with which this transaction originated.
. The prospective lower tier participant further agrees by submitting this proposal that it will include the clause titled ACertification Regarding
Debarment, Suspension, Ineligibility, and Voluntary Exclusion -Lower Tier Covered Transactions,-- without modification, in all lower tier covered
transactions and in all solicitations for lower tier covered transactions.
7. A participant in a covered transaction may rely upon a certification of a prospective participant in a lower tier covered transaction that it is not
debarred, suspended, ineligible, or voluntarily excluded from the covered transaction, unless it knows that the certification is erroneous. A
participant may decide the method and frequency by which it determines the eligibility of its principals. Each participant may but is not required
to, check the Nonprocurement List.
8. Nothing contained in the foregoing shall be construed to require establishment of a system of records in order to render in good faith the
certification required by this clause. The knowledge and information of a participant is not required to exceed that which is normally possessed
by a prudent person in the ordinary course of business dealings.
9. Except for transactions authorized under paragraph 5 of these instructions, if a participant in a covered transaction knowingly enters into a
lower tier covered transaction with a person who is suspended, debarred, ineligible, or voluntarily excluded from participation in this transaction,
in addition to other remedies available to the Federal Government, the department or agency with which this transaction originated may pursue
available remedies, including suspension and/or debarment.
Certification
(1) The prospective lower tier participant certifies, by submission of this proposal, that neither it nor its principals are presently debarred,
suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction by any Federal
department or agency.
(2) Where the prospective lower tier participant is unable to certify to any of the statements in this certification, such prospective
participant shall attach an explanation to this proposal.
NAME OF APPLICANT PR/AWARD NUMBER AND/OR PROJECT NAME
The City of San Bernardino Parks, Recreation and Community Services Department The City of San Bernardino Mentoring Program
PRINTED NAME AND TITLE OF AUTHORIZED REPRESENTATIVE
Lemuel P. Randolph Director ofparks and Recreayop Sgrvices Department
SIGNATURE /J/J DATE
ED 80-0014, 9790 (Replaces GCS-009 (REV.12/88), which is obsolete)
65
2004-251
OMB Approval No. 034"M
ASSURANCES - NON -CONSTRUCTION PROGRAMS
Public reporting burden for this collection of information is estimated to average 15 minutes per response, including time for
reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and
reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of
information, including suggestions for reducing this burden, to the Office of Management and Budget, Paperwork Reduction
Project (0348-0040), Washington, DC 20503
PLEASE DO NOT RETURN YOUR COMPLETED FORM TO THE OFFICE OF MANAGEMENT AND
BUDGET. SEND IT TO THE ADDRESS PROVIDED BY THE SPONSORING AGENCY.
Note: Certain of these assurances may not be applicable to your project or program. If you have questions, please contact
the awarding agency. Further, certain Federal awarding agencies may require applicants to certify to additional
assurances. If such is the case, you will be notified.
As the duly authorized representative of the applicant I certify that the applicant:
1. Has the legal authority to apply for Federal assistance,
and the institutional, managerial and financial capability
(including funds sufficient to pay the non -Federal share
of project cost) to ensure proper planning,
management, and completion of the project described
in this application.
2. Will give the awarding agency, the Comptroller General
of the United States, and if appropriate, the State,
through any authorized representative, access to and
the right to examine all records, books, papers, or
documents related to the award; and will establish a
proper accounting system in accordance with generally
accepted accounting standards or agency directives.
3. Will establish safeguards to prohibit employees from
using their positions for a purpose that constitutes or
presents the appearance of personal or organizational
conflict of interest, or personal gain.
4. Will initiate and complete the work within the applicable
time frame after receipt of approval of the awarding
agency.
5. Will comply with the Intergovernmental Personnel Act of
1970 (42 U.S.C..4728-4763) relating to prescribed
standards for merit systems for programs funded under
one of the 19 statutes or regulations specified in
Appendix A of OPM's Standards for a Merit System of
Personnel Administration (5 C.F.R. 900, Subpart F).
6. Will comply with all Federal statutes relating to
nondiscrimination. These include but are not limited to:
(a) Title VI of the Civil Rights Act of 1964 (P.L. 88-352)
which prohibits discrimination on the basis of race, color
or national origin; (b) Title IX of the Education
Amendments of 1972, as amended (20 U.S.C.,1681-
1683, and 1685-1686), which prohibits discrimination
on the basis of sex; (c) Section 504 of the Rehabilitation
Act of 1973, as amended (29 U.S.C.. 794), which
prohibits discrimination on the basis of handicaps; (d)
66
the Age Discrimination Act of 1975, as amended (42
U.S.C.. 6101-6107), which prohibits discrimination on
the basis of age; (e) the Drug Abuse Office and
Treatment Act of 1972 (P.L. 92-255), as amended,
relating to nondiscrimination on the basis of drug
abuse; (f) the Comprehensive Alcohol Abuse and
Alcoholism Prevention, Treatment and Rehabilitation
Act of 1970 (P.L. 91-616), as amended, relating to
nondiscrimination on the basis of alcohol abuse or
alcoholism; (g), 523 and 527 of the Public Health
Service Act of 1912 (42 U.S.C.. 290 dd-3 and 290 ee
3), as amended, relating to confidentiality of alcohol and
drug abuse patient records; (h) Title VIII of the Civil
Rights Act of 1968 (42 U.S.C.. 3601 at seq.), as
amended, relating to nondiscrimination in the sale,
rental or financing of housing; (i) any other
nondiscrimination provisions in the specific statute(s)
under which application for Federal assistance is being
made; and 0) the requirements of any other
nondiscrimination statute(s) which may apply to the
application.
Will comply, or has already complied, with the
requirements of Titles 11 and III of the uniform
Relocation Assistance and Real Property Acquisition
Policies Act of 1970 (P.L. 91-646) which provide for fair
and equitable treatment of persons displaced or whose
property is acquired as a result of Federal or federally
assisted programs. These requirements apply to all
interests in real property acquired for project purposes
regardless of Federal participation in purchases.
8. Will comply, as applicable, with the provisions of the
Hatch Act (5 U.S.C.,1501-1508 and 7324-7328) which
limit the political activities of employees whose principal
employment activities are funded in whole or in part
with Federal funds.
2004-251
9. Will comply, as applicable, with the provisions of the
Davis -Bacon Act (40 U.S.C..276a to 276a-7), the
Copeland Act (40 U.S.C.,276c and 18 U.S.C.,874) and
the Contract Work Hours and Safety Standards Act (40
U.S.C. , 327-333), regarding labor standards for
federally assisted construction subagreements.
10. Will comply, if applicable, with flood insurance purchase
requirements of Section 102(a) of the Flood Disaster
Protection Act of 1973 (P.L. 93-234) which requires
recipients in a special flood hazard area to participate in
the program and to purchase flood insurance if the total
cost of insurable construction and acquisition is
$10,000 or more.
11. Will comply with environmental standards which may be
prescribed pursuant to the following: (a) institution of
environmental quality control measures under the
National Environmental Policy Act of 1969 (P.L. 91-190)
and Executive Order (ED) 11514; (b) notification of
violating facilities pursuant to EO 11738; (c) protection
of wetlands pursuant to EO 11990; (d) evaluation of
flood hazards in floodplains in accordance with EO
11988; (e) assurance of project consistency with the
approved State management program developed under
the Coastal Zone Management Act of 1972 (16 U.S.C.
1451 et seq.); (f) conformity of Federal actions to State
(Clear Air) Implementation Plans under Section 176(c)
of the Clear Air Act of 1955, as amended (42 U.S.C.
7401 et seq.); (g) protection of underground sources of
drinking water under the Safe Drinking Water Act of
1974, as amended, (P.L. 93-523); and (h) protection of
endangered species under the Endangered Species
Act of 1973, as amended, (P.L. 93-205).
12 Will comply with the Wild and Scenic Rivers Act of 1968
(16 U.S.C..1721 et seq.) related to protecting
components or potential components of the national
wild and scenic rivers system.
13. Will assist the awarding agency in assuring compliance
with Section 106 of the National Historic Preservation
Act of 1966, as amended (16 U.S.C., 470), EO 11593
(identification and protection of historic properties), and
the Archaeological and Historic Preservation Act of
1974 (16 U.S.C, 469a-1 at seq.).
14. Will comply with P.L. 93-348 regarding the protection of
human subjects involved in research, development, and
related activities supported by this award of assistance.
15. Will comply with the Laboratory Animal Welfare Act of
1966 (P.L. 89-544, as amended, 7 U.S.C, 2131 et seq.)
pertaining to the care, handling, and treatment of warm
blooded animals held for research, teaching, or other
activities supported by this award of assistance.
16. Will comply with the Lead -Based Paint Poisoning
Prevention Act (42 U.S.C, 4801 et seq.) which prohibits
the use of lead- based paint in construction or
rehabilitation of residence structures.
17. Will cause to be performed the required financial and
compliance audits in accordance with the Single Audit
Act Amendments of 1996 and OMB Circular No. A-133,
DAudits of States, Local Governments, and Non -Profit
Organizations.❑
18. Will comply with all applicable requirements of all other
Federal laws, executive orders, regulations and policies
governing this program.
SIGNATURE OF AUT RIZED CER
TITLE
�F�
Director of Parks & Recreation Services
Department
APPLICANT ORGANIZATION
DATE SUBMITTED
The City of San Bernardino Parks, Recreation and Community Services Department
67
2004-251
Disclosure of Lobbying Activities
Complete this form to disclose lobbying activities pursuant to 31 U.S.C. 1352
(See reverse for public burden disclosure)
1. Type of Federal Action:
2. Status of Federal Action:
3. Report Type:
a. contract
a. bid/offer/application
a. Initial filing
b_ b. grant
_a_ b. initial award
a_ b. material change
c. cooperative agreement
c. post -award
d. loan
For material change only:
e. loan guarantee
Year quarter
f. loan insurance
Date of last report
4. Name and Address of Reporting Entity:
S. If Reporting Entity in No. 4 is Subawardee, Enter Name
x Prime Subawardee
and Address of Prime:
_
Tier , if Known:
The City of San Bernardino Parks, Recreation
and Community Services Department
547 North Sierra Way
San Bernardino, CA 92410
Congressional District, if known: 43rd
Congressional District, if known:
6. Federal DepartmentlAgency:
7. Federal Program Name/Description:
Mentoring Programs
Department of Education Office of Safe
and Drug -Free Schools
CFDA Number, if applicable: _#84 184 B_
7. Federal Action Number, if known:
8. Award Amount, if known:
OMB # 1865-0013
N/A
5
10. a. Name and Address of Lobbying Registrant
b. Individuals Performing Services (including address if
(if individual, last name, first name, Ml):
different from No. 10a)
(last name, first name, Ml):
N/A
N/A
11. Information requested through this form is
authorized by title 31 U.S.C. section 1352. This
Signature:
_
disclosure of lobbying activities is a material
representation of fact upon which reliance was
Print Name: Lemuel P. Randolph
placed by the tier above when this transaction
was made or entered into. This disclosure is
Title: Director of Parks & Recreation Services Department
required pursuant to 31 U.S.C. 1352. This
information will be reported to the Congress
semi-annually and will be available for public
Telephone No.: 909-384-5030 Date:
inspection. Any person who fails to file the
required disclosure shall be subject to a civil
penalty of not less than $10,000 and not more
than $100,000 for each such failure.
Federal Use.Onty
Authorized for Local Reproduction
Standard Form - LLL (Rev. 7-97)
2004-251
INSTRUCTIONS FOR COMPLETION OF SF-LLL, DISCLOSURE OF LOBBYING ACTIVITIES
This disclosure form shall be completed by the reporting entity, whether subawardee or prime Federal recipient, at the initiation or
receipt of a covered Federal action, or a material change to a previous filing, pursuant to title 31 U.S.C. section 1352. The filing of a
form is required for each payment or agreement to make payment to any lobbying entity for influencing or attempting to influence an
officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of
Congress in connection with a covered Federal action. Complete all items that apply for both the initial filing and material change
report. Refer to the implementing guidance published by the Office of Management and Budget for additional information.
1. Identify the type of covered Federal action for which lobbying activity is and/or has been secured to influence the outcome of a
covered Federal action.
2. Identify the status of the covered Federal action.
3. Identify the appropriate classification of this report. If this is a followup report caused by a material change to the information
previously reported, enter the year and quarter in which the change occurred. Enter the date of the last previously submitted
report by this reporting entity for this covered Federal action.
4. Enter the full name, address, city, State and zip code of the reporting entity. Include Congressional District, if known. Check
the appropriate classification of the reporting entity that designates if it is, or expects to be, a prime or subaward recipient.
Identify the tier of the subawardee, e.g., the first subawardee of the prime is the 1st tier. Subawards include but are not limited
to subcontracts, subgrants and contract awards under grants.
5. If the organization filing the report in item 4 checks "Subawardee," then enter the full name, address, city, State and zip code
of the prime Federal recipient. Include Congressional District, if known.
6. Enter the name of the federal agency making the award or loan commitment. Include at least one organizational level below
agency name, if known. For example, Department of Transportation, United States Coast Guard.
7. Enter the Federal program name or description for the covered Federal action (item 1). If known, enter the full Catalog of
Federal Domestic Assistance (CFDA) number for grants, cooperative agreements, loans, and loan commitments.
8. Enter the most appropriate Federal identifying number available for the Federal action identified in item 1 (e.g., Request for
Proposal (RFP) number; Invitations for Bid (IFB) number; grant announcement number; the contract, grant, or loan award
number; the application/proposal control number assigned by the Federal agency). Included prefixes, e.g., "RFP-DE-90-001
9. For a covered Federal action where there has been an award or loan commitment by the Federal agency, enter the Federal
amount of the awardfloan commitment for the prime entity identified in item 4 or 5.
10. (a) Enter the full name, address, city, State and zip code of the lobbying registrant under the Lobbying Disclosure Act of 1995
engaged by the reporting entity identified in item 4 to influence the covered Federal action.
(b) Enter the full names of the individual(s) performing services, and include full address if different from 10(a). Enter Last
Name, First Name, and Middle Initial (MI).
11. The certifying official shall sign and date the form, print his/her name, title, and telephone number.
According to the Paperwork Reduction Act, as amended, no persons are required to respond to a collection of information unless it displays a valid OMB
control Number. The valid OMB control number for this information collection is OMB No. 0348.0046. Public reporting burden for this collection of
information is estimated to average 10 minutes per response, including time for reviewing instructions, searching existing data sources, gathering and
maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other
aspect of this collection of information, including suggestions for reducing this burden, to the Office of Management and Budget, Paperwork Reduction
Project (0348-0046), Washington, DC 20503
2004-251
Project Abstract:
The City of San Bernardino Mentoring Program (CSBMP), established in 1992,
collaborates with 42 Agencies and organizations, including the San Bernardino Unified
School District (SBCUSD) which is classified as a "high need" district in the State of
California. The SBCUSD faces challenges inherent to districts with poverty, mobility,
unemployment, high ethnic minority representation, language differences and lack of
education among parents. Student achievement and success is profoundly affected. All 59
SBCUSD schools qualify for Title 1 funding. San Bernardino County ranks above the
California average in juvenile felony arrest, high school dropouts and teenage pregnancy.
(Data from "Children Now" Newsletter).
The Department of Education Mentoring Program grant will provide an
opportunity to continue serving at -risk youth and their families in this City of 190,232
located sixty miles east of Los Angeles. The program expanded in December 2000 to
reach the mentee families serving 745 people as it maintained 229 Mentor/Mentee
matches and provided services to the mentee families. Funding for this expanded
program ended in June 2004.
Since the end of the California Endorsement Grant, our current Mentor Program
enrolled 56 mentor/mentee matches providing mentoring to at -risk elementary and
middle school children. All the collaborative partners are committed to continuing the
expanded program that began in December 2000 to reach mentees and families.
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❖ Table of Contents:
Item Page
❖
Project Abstract
Page
1
❖
Table of Contents
Page
2
8•
Budget Narrative
Page
3-10
❖
Need for the Project
Page
11-13
❖
Quality of the Project Design
Page
14
❖
Quality of the Management Plan
Page
15-18
❖
Quality of the Project Personnel
Page
18-22
❖
Quality of the Project Evaluation
Page
23-25
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• Budeet Narrative
There are four major project components that will be funded by The
Department of Education Mentoring Program during the requested budget period.
1. Sustain Current Mentee/Mentor Enrollment: Expand enrollment of new Mentors.
Provide orientation and training and increase from 56 to 150 mentor-mentee
relationships by increasing 30 new matches each budget year. The Mentor Program
Coordinator and staff will make regular presentations to various groups and
organization in order to recruit quality mentors to accomplish our goal of 30 new
matches each year.
2. Continue with Monitoring Mentor/Mentee relationship: The Mentoring Program
must ensure that each child assigned a mentor is benefiting from that assignment. A child
will be re -assigned to a new mentor if the relationship is not beneficial to the child. The
Mentor Program Coordinator will spend 25% of her time each budget year in the
monitoring process to assure good mentor-mentee relationships.
3. Continue with the Outreach Workers Services: Given the high -risk target
population, there are many problems in the homes of Mentees that cannot and should not
be addressed through Mentors. Many situations require professional intervention from
public and private community -based organizations. A major activity of funding from The
Department of Education Mentor Program will allow the continuation of two (2) FTE
Outreach Workers. They are responsible for working with Mentors/Mentees, parents and
guardians of 150 families by the end of three-year period. In -home visits will be
conducted to assess the home situation. The Outreach Workers will continue providing
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referrals and follow-up to a variety of health and human services (i.e.. health insurance,
counseling, substance abuse treatment etc.); and continue offering parents and guardians
parenting education classes once a month (Spanish & English). Based on current
program data approximately 75% of Mentees and their families would need outreach
services each budget year.
4. Formal Evaluation Process: The final funded activity will be the planning,
development and implementation of our current formal evaluation process, which has
been developed by the SBCUSD Research Systems Analysis Division to accumulate data,
analyze results, and present reports. The SBCUSD will continue the evaluation process
for us, at a cost of approximately $ 30, 000 for a three-year period.
5. Anticipated Outcomes:
• Increase to 150 Mentor/Mentee matches by the end of the 3rd budget year. This is
based on increasing the 56 current participants by 30 participants each budget year
during the grant period.
• Provide Outreach services to at least 75% of the mentees families referred by
counselors or mentors, by home visitations, parenting classes, and referrals to health,
social and educational agencies as needed. Each budget year we will add new families
to the outreach component as new mentees are added and we expect to reach 75% of
the families each year.
• Continue improvement in social, behavioral and confidence -building skills in at
least 75% of Mentees each budget year, as documented by pre/post surveys
conducted by the School District.
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• Based on current records, show improved academic performance, attendance and
interest in education by mentees each budget year. Reduce the number of absences from
school by 25% among at least 50% of Mentees each budget year.
• Increase grade performance in one subject among Mentees as documented by
school reports each budget year.
• As reflected in school crime reports, we expect to reduce the number of juvenile
delinquent activities, involvement in gang -related activities, use of firearms and use of
alcohol and drugs by mentees each budget year. Seventy five percent (75%) of our
youth Mentees will not have records of involvement with law enforcement or school
police for juvenile delinquent or gang related activities; 75% of our Mentees will not
have been involved in use of or sale of illegal drugs, alcohol or firearms at school or in
the community.
• Increase mentees' interest in school to work transition by participation in
community activities. One hundred percent (100%) of Mentees/Mentors/Parents will
participate each budget year in at least one of the following activities: Mentor Career
Day, Volunteer Day at Mentor Program Office, community events, neighborhood clean-
ups, community gardens, cultural celebrations and events, sports and recreation, fund-
raisers for non-profit groups, or volunteering in community services.
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Budget Information
Budget Categories
1. Personnel:
Position Title Computation Cost
2004-2005
Mentor Coordinator $19.60 per hour x 2080 hours $40,768.00
Administration Clerk II $11.90 per hour x 2080 hours $24,752.00
Two (2) Outreach Workers $11.00 per hour x 1560 hours $34,320.00
x each = $17,160
Total $99,840.00
2005-2006
Mentor Coordinator $20.60 per hour x 2080 hours $42,848.00
Administration Clerk II $12.49 per hour x 2080 hours $25,979.00
Two (2) Outreach Workers $12.00 per hour x 1560 hours $37,440.00
x each= 18,720.00
Total $106,267.00
2006-2007
Mentor Coordinator $21.60 per hour x 2080 hours $44,928.00
Administration Clerk II $13.11 per hour x 2080 hours $27,268.00
Two (2) Outreach Workers $12.50 per hour x 1560 hours $39,000.00
X each= 19,500
Total $111,196.00
2. Fringe Benefits Computation Cost
idtl0111PI Itl►i
Mentor Coordinator $400 per month x 12 months x 3 years $14,400.00
Administration Clerk II $400 per month x 12 months x 3 years $14,400.00
Two (2) Outreach Workers $400 per month x 12 months x 3 years $28,800.00
Total $57,600.00
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3. Travel Item Computation Cost
Local Travel mileage
Long Distance
National Conference
Airfare
Per Diem
2004-2007
16,000 miles @ $.345 x 3 years $5,520.00
@ $350 x 2 people=$700 x 3 years $2,100.00
3 meals @ $80 x 3 days x 2 people
x years $1,440.00
Hotel @ $400 x 3 days x 2 people x one trip
x 3 years $1,200.00
Sub Total $4,740.00
2004-2007
Long Distance
Training Sessions
Airfare @ $350 x one person x 3 times per
Year x 3 years $3,150.00
Per Diem 3 meals @ $80 x one person
x 3 days x 3 times each year
x 3 years $2,160.00
Hotel @ $400 x 3 days x one person x
3 times each year x 3 years $3,600.00
Sub Total $8,910.00
Total $19,170.00
4. Equipment Item Computation Cost
2004-2005
Computer Three (3) One time expenditure
$4,800.00
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5. Supplies Computation Cost
Office Supplies
2004-2007
$1,200 x year x 3 budget years $3,600.00
6. Contractual Computation Cost
2004-2007
Evaluation $10,000 per year x 3 budget years $30,000.00
7. Construction Computation Cost
N/A
N/A
N/A
8.Others Computation Cost
2004-2007
January Annual Breakfast (January National
Mentoring Month) @ $8 per person
x 100 people x 3 years $2,400.00
Monthly Mentor Support Meetings (Lunch)
@ $100 x meeting x 12 months x 3 years $3,600.00
Monthly Parenting Classes (Potluck)
Spanish & English @ $50 each x 10 months
x 3 years $3,600.00
March Annual Job Shadowing @ $30 x person
x 50 youth x 3 years $4,500.00
Monthly Advisory Committee Meetings (Lunch)
@ $50 per meeting x 12 months x 3 years $1,800.00
April Annual Family Picnic (Potluck)
@ $500 per event x one each year x 3 years $1,500.00
June Annual Recognition Program
@ $3,500 per event x 150 people x 3 years $10,500.00
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August Annual Youth Camping Trip at Serrano
Camp -Big Bear San Bernardino Forest
60 youth + volunteers @ $5,000 x 3 days
each year x 3 years $15,000.00
December Annual Family Christmas (Dinner)
@ $7,000 per event x 350 people each year
x 3 years $21,500.00
Total
$64,400.00
9. Total Direct Cost Computation Cost
2004 — 2005 (lines 1 — 8) $162,896
2005 — 2006 (lines 1 — 8) $164,523
2006 — 2007 (lines 1 — 8) $169,452
Total $496,871
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Section B Budeet Summary
8. Other Computation Cost
2004-2005
Volunteer Hours 90 mentors x 4 hours x month x 12 months $71,280.00
(National Average @ $16.50 x hour x one year
for Volunteer Work)
2005-2006
120 mentors x 4 hours x month x 12 months
@ $16.50 x hour x one year $95,040.00
2006-2007
150 mentors x 4 hours x month x 12 months
@ $16.50 x hour x one year $118,800.00
Total
$285,120.00
9. Direct Cost Computation Cost
2004-2005
In -kind Donations 90 mentor finger print, background
Check and TB testing @ $60 each $5,400.00
2005-2006
30 mentor finger print, background
Check and TB testing @ $60 each $1,800.00
2006-2007
30 mentor finger print, background
Check and TB testing @ $60 each $1,800.00
Total $9,000.00
11. Trainine Stipends Computation Cost
2004-2007
New Mentor Training San Bernardino County Health
In -Kind Department Trainer @ $30 x 2 hours
x session x 12 sessions x 3 years $2,160.00
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Parenting Classes Spanish & English Classes
In -Kind Various Agencies Participants as
Speakers @ $30 x hour x 2 hours per session
x 2 sessions x 10 months x 3 years $5,400.00
Total
❖ Need for the Project:
$7,560.00
Today, young people are faced with unprecedented challenges in weaving their
way through a highly complex and threatening society. Policymakers, practitioners and
researchers agree that at -risk youth need positive, consistent relationships with adults to
support their development and success. In high -risk communities, a dearth of such
relationships in families, neighborhoods and institutions has been identified as a key
factor in the difficulties encountered by young people in pursuing a constructive life path.
It is no wonder that the usefulness and viability of mentoring has been the focus of many
community -based programs as a method to establish reciprocal bonds through caring
support.
The City of San Bernardino Mentoring Program (CSBMP) is comprised of
students from 22 elementary and 4 middle schools, which is almost 50% of the San
Bernardino City Unified School District (SBCUSD), the tenth largest school district in
the state of California. SBCUSD serves approximately 48,000 students in grades in K-12
at 59 schools. The SBCUSD faces challenges inherent in urban schools where poverty,
mobility, unemployment, high ethnic minority representation, language differences and a
lack of higher education in families profoundly impact student's achievement and
success.
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Data obtained from SBCUSD Office Research and Development and University
of California, Riverside Office of Community Research indicate that students in the
SBCUSD are negatively affected by the following factors:
• All 59 of SBCUSD's schools qualify for Title 1 funding.
• 80.5% of the School District population live in poverty.
• The City of San Bernardino tops the county list with the highest reliance upon public
assistance (38% of all residents receive some type of welfare). This also negatively
impacts the academic success of students.
• Nearly 95% of all SBCUSD students participate in the Free/Reduced Lunch program.
• The number of Limited English Proficient students in the county has grown 150% in
ten years with a negative impact on academic success of students.
• 77% of students in the school district are ethnic minorities (African American: 20%;
Asian: 4%; Hispanic: 52%; Native American: 1%; White: 23%).
• 16% of families with children live below the poverty level; 56% of female -headed
households with children under age 18 live in poverty.
• Large numbers of parents of the children commute long hours to the workplace in
neighboring counties (Los Angeles and Orange), increasing the time they are absent
from the family home, thus leaving more children unsupervised and/or without adult
guidance.
• An attendance problem, high rates of mobility between schools and higher than state
averages dropout rates.
• In the most recent reported year, the live teen birth rates ranged from 20.5 per 1,000
Whites, to 63 per 1,000 for Hispanics, with African Americans in-between.
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These factors contribute to an extremely challenging learning environment, and
present many risk factors for healthy physical and emotional development. The CSBMP
serves a valuable role in the community by providing early intervention, reaching
students earlier in life, before serious and/or negative behaviors begin to emerge. Also,
the long-term impact of the program relates to reduction in juvenile delinquency, gang
participation, school drop out rates, and improvement in academic performance, better
health and well being, and community involvement. Social research by the SBCUSD
suggests the benefits of natural, personal helping relationships as an antidote for the
complex myriad of youth problems, which if left unattended, escalate into life changing,
and life threatening behaviors. Mentees develop healthier attitudes towards adults and
authority figures, in general. One key difference between youth who become successful
and those who do not is a Mentor.
With Department of Education Mentoring Programs Grant funding, we will
elevate the existing program to a new level by continuing to serve the entire family unit
of each Mentee through outreach services. Mentors have informed project staff that their
role would be much more effective if the parents/guardians/family were involved in a
more meaningful manner. After we received The California Endowment grant for
Outreach to families in December 2000, we began to work with Mentees' families. As a
result many fundamental problems experienced by Mentees and family members at home
have been resolved. Families' are referred to various health, legal and social agencies as
necessary to meet their needs. In addition, the mentoring program provides monthly
parenting classes in both Spanish and English.
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❖ Ouality of the Project Design:
The program, established by the City of San Bernardino, Parks, Recreation and
Community Services Department in April 1992, was originally designed to focus on
academic success in school through improvement in reading, study skills and work
habits. Thirty-five City employees were matched with first, second and third grade
students identified by teachers as potential beneficiaries of Mentoring relationships. They
volunteered during their lunch hours, one day per week. Besides tutoring students,
mentors focused on serving as role models, developing life skills and sharing adult
values. By 1995, a private non-profit organization assisted in the development of a City
Youth Agenda and the formation of The City of San Bernardino Mayor's Youth Task
Force. They proposed that the Mentoring program begin to serve middle schools where
many problems with at -risk youth were evident. The City and the School District
redirected funds from the various grant programs supporting Mentoring to hire a Mentor
Coordinator to oversee the program for middle as well as the elementary schools.
In 1997, a three-year Juvenile Mentoring Program (JUMP) grant was awarded
from the U.S. Office of Justice Planning, expanding the number of school sites from 3 to
15. The program has received certification from the California Mentor Initiative (CMI)
and Governor's Mentoring Partnership. In December 2000, after receiving a grant from
The California Endowment, the Mentoring Program expanded the number of sites to 22
elementary and four middle schools.
4. Ouality of the Management Plan:
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From 2000 through 2004, a total of 229 students mentees have been matched with
229 Mentors, providing a direct link for reducing the risk factors for problematic and
anti -social behaviors among youth (school failure, juvenile delinquency, alcohol and
drugs, teen pregnancy, gangs, and violence). Intervention is provided, by having a
consistent one on one relationship and a caring role model that provides guidance,
friendship, and encouragement for healthy alternatives. As a result, mentees increase
grades, develop communication and life skills, and decrease absences and drop out rates.
These results are confirmed by reports of our schools counselors, teachers, and mentors.
The relationship between parents and mentees is improved by having various activities in
which both are involved. Parents are also involved in Parenting Classes in Spanish and
English. In the CSBMP, 57% of participants are Hispanic, the majority of whom have
limited English proficiency. Classes have specific topics that increase the information and
referral opportunities to develop the process for meeting needs in the entire family.
The target population for the program is at -risk elementary and middle schools
students (41n-8 h grade). There are 26 eligible and participating schools, which are in high
crime areas with 56% or more of their enrollees eligible to receive Title 1 funds under the
Elementary and Secondary Education Act. Students are considered "at -risk" by the
following criteria:
• Performing significantly below grade level
• Economically disadvantaged
• Child of alcohol or drug abuser
• Teen Pregnancy
• Mental Health Problems
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• Victim of child abuse/neglect
• Gang involvement or other pre -delinquent acts
A Coordinated effort allows youth at school sites to be referred by school
counselors. Counselors are well aware of which students are exposed to high levels of
risk in their family, community or social environment that may lead to educational
failure, dropping out of school, or involvement with juvenile delinquency. Students who
are identified for the CSBMP are required to complete a Student Application and obtain
written parental permission for participation in the Mentoring Program.
The mentor's first meeting will be at the school site. During this preliminary
meeting the mentor will meet all appropriate school personnel such as the principal, vice
principal, health aide/counselor, and front office workers and parents/guardians. Mentors
will have a tour of the school site and be shown appropriate mentor/mentee meeting
places on campus. The school's staff will be able to identify the mentor on future visits.
This overall informational session will serve to avoid any possible pitfalls during the
initial visit. The family and mentor's files will be maintained at the Mentoring Program
office as confidential information.
Monitoring the mentoring relationship is a daily task for the school and Mentoring
Program staff. This is accomplished with phone calls, sign -in sheets, interview, short
meetings, talks with parents and mentee, and mentor information. If during the mentoring
time, for any reason, mentee or mentor is not comfortable with each other, it is not
considered failure; however, the mentee and mentor will be reassigned as soon as
possible.
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The CSBMP actively seeks volunteers who are at least 21 years of age who can
meet the rigorous screening requirements to serve as " Mentors" to at -risk youth at
participating schools. The term" Mentor" suggest a relationship between a supportive
older adult and an unrelated, younger protege (Mentee). The Mentor provides on -going
guidance, instruction and encouragement, which support the development of competence
and character in the student. The San Bernardino Mentoring Program is operated on a
non-discriminatory basis, affording equal treatment and access to service without regard
to race, color, religion, national origin or ancestry.
Screening policies and procedures are part of the Mentoring program, which
includes application, personal interview, references, fingerprints, criminal background
check, car insurance, and TB Testing. Mentors are provided with an orientation, three-
hour training in "Identification of risk factors for children", and testing. In addition, they
attend monthly support meetings with fellow Mentors, as well as one on one support with
the Mentoring Program Coordinator.
CSBMP Mentors make a written commitment to work for one full school year
(majority of schools are year-round) with their Mentee. Mentors/Mentees meet a
minimum of one hour per week at the school campus to work on improving academic
skills and dealing with life's issues. Mentors also enjoy specially scheduled social,
recreational, educational, cultural, and enrichment activities with their Mentees. The
Program provides family Picnics, family Christmas Parties, and a Recognition Program
where mentors, mentees, and family members may have special time together.
Mentors also make a commitment to bring their Mentee to their work place in
order to make a strong case for the direct link between academic and career success (Job
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Shadowing). Mentor/Mentee matches are based on the academic, behavioral, and cultural
needs of the children. The Mentor Program Coordinator conducts one on one separate
interviews and written applications for both Mentor and Mentee, then the mentor and
mentee meet each other at the school sites in the presence of the school counselor and
Mentoring Program Coordinator. This process helps ensure that the right mentors are
chosen in the beginning, so that longstanding relationships with the children they mentor
will develop.
❖ Ouality of Project Personnel:
The City of San Bernardino Parks, Recreation and Community Services
Department is a municipal agency mandated to provide parks, recreation and social
services to the residents of the City of San Bernardino. The Department operates on an
annual budget of over $4.7 million, with a history of successful administration of both
internal operations and federal and state grants. The Department has administered HUD
and USDA grants for summer and year round Lunch Programs for disadvantaged youth
for over 20 years.
The Department has a long history of community collaboration, and has worked
with the SBCUSD for over two decades. In addition to the CSBMP, the Department has
had extensive experience in providing school-based/school-linked services through
collaboration with numerous health and human service agencies involved with the
Healthy Start Program. The Department has developed and implemented extended social
and recreational services at numerous school sites, and has worked collaboratively with
the San Bernardino City Unified School District on many projects, including Healthy
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Start, After -School Programs (CAPS), After -School Gardening Program, Healthy
Families and California Kids.
The City of San Bernardino Mentoring Program staff has attended and will
continue to attend various training workshops, conferences, and other professional
development seminars such as the "National Mentor Summit" and "Managing the Risks
of Mentoring". In previous regional and state planning meetings, we discovered that the
City of San Bernardino Mentoring Program has one of the largest numbers of successful
Mentor-Mentee matches in Southern California. In addition, ours is one of the few
programs in California that has been working with the outreach component, to include
parents, family members and parenting classes with information, documentation,
brochures, and flyers in both Spanish & English.
The professional staff of the CSBMP includes a bilingual (Spanish & English)
Mentor Coordinator with 23 years of professional experience. The Coordinator has
developed two new components to the Mentoring Program to include the families of
mentees. One component is the Parenting Class where training in various areas is offered.
Parents meet monthly to discuss needs of the families and work together with the
outreach workers. The other is a family Outreach Program in which home visits are made
to assess family needs and make referrals to other agencies as necessary. Prior to
becoming The Mentor Coordinator for San Bernardino Parks, Recreation and Community
Services Department, the incumbent spent the previous 19 years involved with at -risk
youth and 18 years as a parenting class coordinator as well as a community volunteer.
She has a Bachelor and Master's degree in the human development field. She also has
worked in various programs as ALANON, for families of drugs and alcohol abusers,
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"Families Together," a program for keeping families together without abuse by having
a commitment from a former abuser, and "Woman for Life," a program for helping
single parents. The Coordinator has been involved in all aspects of recruitment, training,
and support of mentors. She has also worked on the development of the Advisory Board,
monthly mentor support meetings, parenting classes (Spanish & English), and
implementation of a recreational component of the program. The Coordinator has been
very active in promoting the program through various community activities such as
Family Picnics, Mother's Day Celebration, an annual Recognition Luncheon, Camping
trips and a Christmas program, and numerous other social and cultural activities. When
the City received the California Endowment Grant in 2000, an Assistant Administration
Clerk and two Outreach Workers were added to complete the work for the mentor/mentee
matches, parenting classes, and outreach to families. The employees received initial
training and addition update training once each month with new information to assist
them in making successful home visitations, complete paper work, and communicate in
both Spanish & English. With the addition of funding from this Education Department
Grant, these programs can be re -instituted.
The following is a brief profile of other Mentoring partners:
❖ Mentors are recruited in various institutions such as hospitals, government and
private agencies, schools and universities, etc. In these recruitment efforts, we provide
a professional presentation with information and experiences about mentoring and then
allow time for attendees to ask questions and complete an application to be a mentor.
2004-251
❖ San Bernardino City Unified School District: The CSBMP meets as often as
required but at least weekly with school counselors and other school officials to make
mentor/mentee assignments and to keep abreast of the needs of students.
❖ Friends of San Bernardino City Parks: a Non-profit 501 (c) (3) Corporation whose
primary objectives are to aid, sponsor, promote, advance and assist in the provision of
public parks, recreation, and community services in the City of San Bernardino. The
Friends provide the CSBMP with sustainability opportunities beyond the grant period
as a conduit for attaining private funds for the Mentor Program.
❖ City of San Bernardino Mayor's Youth Task Force: It was established in 1995 in
response to the community's desire to see a youth agenda to respond to the growing
number of problems among the city's youth population. It has diverse representation
from the community (SBCUSD Board of Education, City Council members, law
enforcement, the Mayor's office and Parks, Recreation and Community Services
Department). In addition to conceiving the Mentoring Program, the Task Force worked
closely with the City and the school district to secure funding and support to make the
program work. The Task Force has demonstrated their commitment to the Mentoring
Program by assisting in the recruitment of Mentors, serving on the Mentor Advisory
Board, and also volunteering as Mentors themselves.
❖ San Bernardino Mentoring Program Advisory Board: This Board meets on a
monthly basis to bring expertise and collaboration to the project. The Board assists
with many aspects of the program, including Mentor Recruitment, program
development, fund development and special events. The Board membership includes
school staff, the business community, County Department Staff, non-profit
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organizations, churches, parents, and Park, Recreation and Community Services
Department staff.
❖ Quality of the Proiect Evaluation:
One of the major areas that the CSBMP focuses on is the need to demonstrate and
document the impact of the project. This is extremely critical to sustainability of the
project, as most funding sources require a formal evaluation process that presents data
validating the efficacy of their investment.
The CSBMP contracted with SBCUSD for evaluation of the program. This
evaluation enhances the Mentoring Program by rigorously evaluating the exposure and
intensity. The evaluation is useful for giving direction for the program, for making any
changes that may be necessary for improving our services to the children and their
families and also for indicating the impact that the program is having on the academic,
behavioral and cultural situations, that have caused the students to be referred to the
program.
The Evaluation protocols include both process and outcomes evaluation
measures including:
•:• Pre/Post Surveys of Mentors/Mentees and Parents/Guardians to determine quality
and benefits of experience (also includes exit interviews, focus groups, etc).
❖ All consents, recruitment, tracking and retention procedures necessary for the
progress of a longitudinal perspective study.
❖ Programs and controls to assess changes in attitudes, and intents regarding personal
life options, self-concept, social support, and high -risk behaviors.
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❖ Examination of supporting documentation (school records, case management files,
other assessments to measure changes in students performance and achievement).
❖ Attainment of the stated goals and objectives of the program.
❖ Securing additional funding resources to sustain/enhance/expand the program.
❖ Analysis of Risks and Benefits
The benefits of the CSBMP far outweigh the challenges. This is substantiated by a
formal evaluation process that evaluates the progress of each mentee from the time they
begin the program. In addition, we have anecdotal information from mentee/ mentors,
school counselors, and parents and guardians regarding the improvement in the physical,
emotional, social and academic status of students. We also have an information case file
that confirms the outcomes of the program relative to the entire mentee family.
The benefits are evident among both the mentees and the mentors, who report
great satisfaction with their relationships. Volunteers commit to becoming mentors for
many reasons:
❖ A desire to give back to the community.
❖ Because of their area of education study.
❖ Because someone was there for them when they were growing up.
❖ Because they did not have someone growing up, and they want to prevent that
from happening in another child.
❖ Some simply volunteer because they care for and enjoy working with children.
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The biggest risk and challenge is ensuring that a mentor/mentee match has the
greatest potential to provide positive results for the child. Careful screening and thorough
orientation of mentors accomplishes this challenge. Another challenge is maintaining the
level of commitment by mentors while waiting for background investigation results and
coordinating an appropriate match.
Many mentors have lasting relationships with their mentees. Seeing their students
improve in academics, behavior, and healthy habits may take some time, but it is a very
rewarding experience. Some mentors look for immediate results and when good things do
not happen quickly, they become discouraged in their efforts. Staff support and
encouragement is extremely important in order to assure the Mentor that they are making
a difference.
Another risk is that the mentee family may become dependent on the mentor to
solve family problems. While mentors are well intentioned, this is clearly not their role.
Ongoing training and consultation between mentors and professional staff is essential to
prevent these challenges. The addition of case management staff has been a great benefit
to the mentors, and addresses the needs of all involved in getting the appropriate
resources when they are needed.
24
Jo, Ed.D.
ntendent
Narciso Cardona
Assistant Superintendent
July 7, 2004
To Whom It May Concern:
The San Bernardino City Unified School District has a long-standing relationship with the City
of San Bernardino Parks, Recreation, and Community Services Department. This department
has provided mentoring services to our district students since 1992. The City of San Bernardino
is currently in the process of applying for grant funding to continue and expand their mentoring
services to our students.
The San Bernardino City Unified School District is in support of the grant application and we are
looking forward to establishing a Memorandum of Understanding to partner with the City to
obtain the needed mentoring support for more of our students. The mentoring of students has
been an effective intervention in improving attendance and academic achievement for our at -risk
students.
The City has requested that our Research Systems/Analysis Department implement an evaluation
process to adhere to the requirements of the mentoring grant. We will certainly work with the
City of San Bernardino to enter into an agreement to do this work. We are preparing a
Memorandum of Understanding to present to our Board of Education for approval by August 17,
Yo rs truly,
N COSOCfNA
Assistant Superintendent
Student Services Division
STUDENT SERVICES DIVISION
777 North F Street ♦ San Bernardino, CA 92410 ♦ (909) 381-1280 ♦ Fax (909) 381-4989
District Web Site: www.sbcusd.kl2.ca.us ♦ E-Mail: narciso.cardona@sbcusd.kl2.ca.us
2004-251 S)� M PL E
City of San Bernardino
Parks, Recreation and Community Services
Department
MEMORANDUM OF UNDERSTANDING
July 6, 2004
The agreement is entered into by the following partners:
City of San Bernardino Parks, Recreation and Community Services Department
(CSBPRCSD): The City of San Bernardino Mentoring Program (CSBMP) under the
umbrella of CSBPRCSD, established in 1992, collaborates with the San Bernardino City
Unified School District (SBCUSD) which is classified as a "high need" district in the
State of California.
San Bernardino City Unified School District (SBCUSD): For the past twelve years the
SBCUSD has been the main partner with CSBMP for providing students who are referred
by school counselors for participation in the Mentoring Program.
The above listed Partners agree to the following:
1. The Department of Education grant will provide an opportunity to continue
serving at -risk youth and their families in the City of San Bernardino with the
partnership of the SBCUSD and CSBMP.
2. The partnership between the SBCUSD and CSBMP will assure that the program
will increase to 150 Mentor/Mentee matches by the end of the 3'd budget year.
This is based on increasing the 56 current participants by 30 participants each
budget year during the grant period.
3. The specific strengths brought to the Partnership by SBCUSD Partner are the
identification and referral of students to the Mentoring Program, the frequent
communication between School counselors and the Mentoring Program to keep
abreast of the needs of students and the planning, development and
implementation of a current formal evaluation process which will be developed
by the SBCUSD Research System Analysis Division at a cost of approximately
$30,000.00 for a three-year period.
4. The City of San Bernardino Mentoring Program's role is to provide early
intervention to reach students before serious and/or negative behaviors are
developed. Early intervention will assist in reducing or eliminating juvenile
delinquency, gang participation, school drop out, and will improve academic
performance, better health and well being, and community involvement.
2004-251 6 W r L r
5. The San Bernardino City Unified School District responsibilities shall be as
follows:
• Counselors shall conduct screening and application process for each child
referred to the Mentoring Program.
• Provide assurance that all appropriate school personnel such as the principal,
vice principal(s) health aide and front office workers are aware of actual and
future interaction of mentor/mentee and Mentoring staff at school site.
• Provide assurance that Mentoring Program staff will receive a quarterly copy of
student's transcripts. This will be used as comparison data to track student's
progress.
• Provide assurance that the Mentoring Program staff will have ongoing
communication with school counselors and teachers.
• Provide assurance that the front office workers will ask the mentor for picture
ID and have them sign -in and sign -out on the proper sheets.
6. The City of San Bernardino Parks, Recreation and Community Services
Department Mentoring Program responsibilities shall be as follows:
• Assess children between 7 and 14 years of age, for mentoring services.
• Provide fingerprinting for new adult mentoring volunteers.
• Provide a mentor for a minimum of one hour per week at the school site.
• Provide parenting classes for the mentee's family members. Classes will be held
once per month for three hours.
• Maintain all records required to provide the information as requested by the
grant.
7. SBCUSD and CSBMP mutual responsibilities are as follows:
Agree to use the Quality Assurance Standards of February 2002, Publication No
(ADP) 01-1121 that assure that no mentor will be assigned to mentor so many
children that the assignment will undermine the mentor's ability to be an
effective mentor or impair the mentor's ability to establish a close relationship
(one-on-one) with each mentored child.
• Agree to match mentor/mentee relationships by gender (Specifically male -male
and female -female)
2004-251
S /gym [l- F
• Assure that the Mentoring program will provide children with a variety of
experiences and support, including:
a. Emotional support
b. Academic assistance
c. Exposure to experiences that the children might not otherwise encounter
on their own; i.e., job shadowing, family picnics, field trips, etc.
• Assure that the mentoring program will be monitored to ensure that each child
assigned to a mentor benefits from that assignment and that the child will be
assigned a new mentor if the relationship between the original mentor and the
child is not beneficial to the child.
This Memorandum of Understanding describes services to be rendered under
contract with the City of San Bernardino Parks, Recreation and Community
Services Department Mentoring Program and San Bernardino City Unified School
District.
Signed and agreed by:
For the San Bernardino City Unified School District:
Narciso Cardona
Assistant Superintendent
Date:
For the City of San Bernardino Parks, Recreation and Community Services
Department
Lemuel P. Randolph
Director of Parks, Recreation and Community Services Department
Date:
2004-251
ARDINO
DEPARTMENT OF PUBLIC HEALTH COUMANSNTY OF RAKERSSAN STEM
��!.� HUMAN SERVICES SYSTEM
PERINATAL 6 ADOLESCENT LIFE SECTION (P.A.L.S.)
505 North Arrowhead Avenue, Suite 201 • San Bernardino, CA 92415-0048
(909)388-5600 • Fax (909)388.5620
July 2, 2004
USA Department of Education
Application Control Center
Attn: CFDA84.184B
Washington, DC 20202
Re: City of San Bernardino Mentoring Program
JAMES A. FELTEN, MPA
Programs Administrator
ERIC K. FRYKMAN, MD, MPH, MBA
Health Officer
The County of San Bernardino Department of Public Health Perinatal and Adolescent
Life Section (PALS) is pleased to recommend and support the City of San Bernardino
Parks and Recreation Department Mentoring Program in its efforts to continue to provide
mentoring services to youth in San Bernardino.
Since 1997, our agency has collaborated with the Mentoring Program in the State of
California Office of Family Planning Community Challenge Grant effort to reduce teen
pregnancy. We are familiar with its efforts to provide programs to at risk youth in the
San Bernardino community. The Mentoring Program in particular has had a successful
history in this effort. The addition of outreach services and of parenting groups further
enhanced the success of this program. Mentors receive support from the staff of the
mentoring program to assure a positive relationship between the mentor and mentee. In
addition to training and ongoing support for the mentors, group activities have brought
the mentors and mentees together and provide a variety of experiences including camping
and participation in the arts.
The Department of Public Health PALS section will continue to collaborate with the
Mentoring Program in the support of mentor/mentee matches and programs to middle and
high school age youth. The youth benefit from a significant adult in their life who
encourages them to establish life goals and to be successful in their goals. We
appreciate the opportunity to continue to support the Parks and Recreation Department in
its endeavor to improve the lives of children in San Bernardino County.
Sincerely,
r �
Karen Zukrow, SW
Supervising Social Service Practitioner
FOCUS Project Coordinator
)03 g � a uviwtung Lo., inc.
Serving the communities of San Bernardino • Colton • Rialto 9 Volume 37, No. 13
a.n, hncuiees participating in the City of San Bernardino Mentoring Program enjoyed an easy
morning breakfast held at the Senior Citizen center in San Bernardino. (I to r) Narcisco Cardona, SBCUSD
Assistant Superintendent, Andrew Saucedo, Janet Ward, Kandice Glerman and Terri Cardinal.
By Diana Macias Harrison
ow many people can say
they have made a signif-
icant difference in a
child's life9 if ,you were to ask one
Of the rice[ 400 participants in die
Ciry ' l San Bernardino
!ventoring Program an m er-
whelming "We have"'response
would he heard.
On Jan. it panciPants in the
City of San Bernardino)
Mamoring program mine togeth-
er for an early morning hreakfast
held :u the Sort Bemardanu Senior
C'inze❑ Ccnter. Tables min color -
'Id hall( ors. dac ;rigid (,I lreshk
haked hrcaktas[ eurees and music
With a )urzv he:, wale guest
as diev entered the huildiri
Jhe trc k!tat t k t he first
anrua: rem » t.[ v:cr., the orga-
mzattun has held. During the hour
.G 1is wC[e
' eued t. si%dru gtlesl speaker
iac'udiny w-,rds from the men-
u{r..
-'this i; the hcsl jo,n I have ever
had," commented CTins Maggio.
kicerside Citizen's Business
B:rtx President. " 13csidas being :
parent dlk is one')! the hig��nsf
experiences of my life." M,tg•1 n
knows of what he speaks. W ha
heen a mentor to I z-year ri d
Andrew Ivloya for the pad face
years.
.'it is not easy," he replied. You
have to he dedicated and imve j
heart to do this." Magglc adnnin
when he stancd the prrn=r.ni it,,
considered giving up,dter the firer
meeting with Moya. 'Whuh we
first sat down and nict I was the
urdy one uhn did dlc tolk!ng '.
scud Maggio. "Afcr ilia[ meeting
I wanted to gr.0 up- but was
raged ' „nc i4c ether
., ;tor, i; ,. ter. .. Ili . ;1. I.ai&, I
t:a glad 1 alit. 1 h:rvc seer ;rcrnl-
No chamee-.:r �1.n: uncr i<t ;h,�
p asl :ivc
�1':ugl„ .. ,. � , y;l, . �•l7r{fir
'!Ps Prn ti : lure` W irl is
cinhdav c.rsc thl ut.nr.,a. -
W'ard cxpLi I:ed she ; ru Sa;a'e.':.
Pen ume 01`011er read`nc t,t
; '. arc. t r y ig � S t i.:,•.,
Tim Cardir.<d has I,ten a me.,.
t,u ❑, K;aldicte German Gar the
Past two years. -'h is worth it to
make a difference in someone's
Idle," she commented. "This exPe-
nence has teen good forme and it
is worth it to dedicate the time."
Cardinal and Giennavn spend their
unie shopping. going out to Iwnch
:uW dinner trill snnueltnes the two
just '.hangout` and talk atoul
things. Though Cardinal is a tull-
utne student she fecis it is unpor
taint In make the time for
Giernan. Sam Gutierrez shares
:es success
.the sentiments of his fellow men.
u,rs. Gutierrez has been a mentor
to Ihica Medina for fn-e years
and sees much success it
Medina's iLure. "[ have truly
enjoyed w;achh;g Diego grow
physically and thritigh his acade-
mics," Gntierrez fondly replied. --I
feel honored and blessed to be a
Part of his life." Gutiercz added
that he plaits to mnuinarc Medina
for the Inland Empire Future
Leaders Program.
Afentees were given an vPporhl-
nity to speak. Lut their experi-
ences with their mentors but most
were too shy. Mentces preferred
Odle Oil one cmisersalipns and
sharing private tikes with their
mentors.
DurmIr ihr hre iki,Its
t Narcisc.....-
Cardona, San Bernardino Cite.
Unitied Sihool District Assistant
Superintendent, stwred it few
tt,ords atvnu 0T mr.uonng Pro -
grain. "Kids di.it ire mentored
!lave a ILtter chance ,hf graduating
...,ht lugh sch a,;. Lc cxpiaimc
'bLuhc kids invoice; veldt the
Mentoring program arc from
smlgghng backgrounds and with
a mentor they have a better
chance at success."
The City of San Bernardino
btenroring Program strives to
inaintain an average of 150
snatches. Over the past two years
die organization has exceeded that
number with 20) matches.
For information re_oarding the
Gle of San Bernardino
Mcntoring Program call (909)
885-1847
;�Y.ter ,ir;ass ga. Riverside branch president Chris Maggio
Andrew Maya.
STATE CAPITOL
ROOM 4074
SACRAME,NTO. CA 95814 4900
6) 4450128 FAX
822 N. EUCLID AVENUE
SUITE A
ONTARIO. CA 91762
1909) 984-7741
(9091 984 6695 FAX
357 WEST 2ND STREET
SUITE 1
SAN BERNARDINO, CA 92401
(909) 38L3832
(909) 381-0739 FAX
505 S. GAREY AVENUE
POMONA. CA 91766
(9091 469 9935
(9091 469 9206 FAX
July 1, 2004
2004-251
C�ttliforma $- tate Senate
SENATOR
NELL SOTO
THIRTY-SECOND SENATORIAL DISTRICT
Ms. Eustolia Heams
Coordinator, Mentoring Program
City of San Bernardino
547 Sierra Way
San Bernardino, Ca 92410-4816
Dear Ms. Heams:
COMMITTEES:
PUBLIC EMPLOYMENT AND
RETIREMENT (CHAIR)
GOVERNMENTAL ORGANIZATION
INSURANCE
LOCAL GOVERNMENT
TRANSPORTATION
VETERANS AFFAIRS
SELECT COMMITTEEi.
URBAN ECONOMIC
DEVELOPMENT (CHAIR)
ALAMEDA CORRIDOR EAST
CALIFORNIAIMEXICO
COOPERATION
CALIFORNIAS HORSE RACING
INDUSTRY
DEFENSE AND AEROSPACE
INDUSTRY
RETIREMENT INVESTMENT
PROTECTION AND CORPORATE
RESPONSIBILITY
URBAN LANDFILLS
RE: Recommendation for City of San Bernardino's
Application for "Mentoring Program, Dept. of Education"
I am writing this letter to support the City of San Bernardino's application for a "Department of
Education Mentoring Program" Grant. I understand that the funds will be used to expand
greatly needed program services to at -risk youth and their families in San Bernardino.
It is my pleasure to attest to the program's effective and efficient delivery of services to youth
and their families through my observations and participation in numerous events your
program has sponsored, including luncheons, dinners, and awards functions. Also, I was
highly impressed with your successful collaborated efforts with numerous organizations and
individuals to provide Christmas gift baskets for needy families in San Bernardino. To be
sure, the families always appeared very grateful for the program.
Under your competent leadership, the Mentoring Program has served 745 people and
maintained 229 Mentor/Mentee "matches." With funds from the proposed education grant,
your program will be able to expand these critically needed services to 120 new mentees.
The City of San Bernardino's Mentoring Program deserves the highest consideration for this
extremely needed service in my District, and I hope your application will be accepted for
funding. If I can be of further assistance, please call my San Bernardino District office at
(909) 381-3832. Good luck!
Sincerely,
__4
NELL SOTO
Senator, 32nd District
NS:fv
20� 4-251
F
Y �
s-
JOE BACA
MEMBER OF CONGRESS
July 6, 2004
USA Department of Education
Application Control Center
Attn: CSDA4.184B
Washington, DC 20202
To Whom It May Concern:
This letter comes to support the attached proposal submitted by the City of San Bernardino
Mentoring Program.
Since 1992 the City of San Bernardino Mentoring Program has been dedicated to educating,
mentoring, and guiding the youth in the city of San Bernardino. San Bernardino County ranks
higher than the California average in the areas of juvenile felony arrest, high school dropouts and
teenage pregnancy.
The City of San Bernardino Mentoring Program has expressed to me its desire to pursue and
secure a grant from the Department of Education that has been created specifically for mentoring
programs. I support and continue to encourage funding to the City of San Bernardino Mentoring
Program to provide resources that will assist this organization and allow them to continue to
serve at -risk youth and their families.
The success of the San Bernardino Mentoring Program can be seen in their fourteen years of
service to the City of San Bernardino. Unfortunately, funding for many expanding programs
ended in June 2004. The mentoring program has a positive reputation for effectiveness and will
be able to reach its highest potential yet with additional funding from the Department of
Education.
Sincerely,
--- j�a_e,
BACA
mber of Congress
rd Congressional District
PAID fOR BY FW4vvS OF JOE BAG.
2004-251
State Capitol
P.O. Box 942849
0sacramento, CA 94249-0001
(916) 319-2062
Fax(916) 319-2162
District Ottice
201 North'E" Street, Suite 205
San Bernardino, CA 92401-1520
(909) 369-1413
Fax (909)366-1176
website: www.assembly.ca.govAongville
email: john.longvilletDasm.ca.gov
July 1, 2004
CASSenthig
(i�ttlifarixir� �1P$islttfixr�
John Longville
Assemblymember, Sixty -Second District
Eustolia (Tola) Hearns
Mentor Program Coordinator
City of San Bernardino
547 Sierra Way
San Bernardino, CA 92410-4816
Dear Ms. Heams:
Chair
Elections, Redistricting
and Constitutional Amendments
Committee Member
Arts, Entertainment, Sports,
Tourism and Internet Media
Govemmental Organization
Human Services
Judiciary
Transportation
It is with great pleasure that I express my support to the City of San Bernardino Mentoring
Program, which under the direction of Ms. Hearns, has assisted in providing children with role
models as well as in providing parenting classes to families in need. The program is also
responsible for organizing cultural events for various ethnic groups, as well as camping and
sports activities for children.
We respectfully urge you to continue providing support to this program in our community. The
existence of such a program is essential towards developing productive and influential youth,
that without such mentoring would have a high probability of becoming at -risk youth due to the
poverty level in our community.
I appreciate your consideration and attention to this matter.
Sincerely, �4A
Jo Longville
Al semblymember, 62nd District
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